Feasibility of melatonin for prevention of delirium in critically ill patients : a protocol for a multicentre, randomised, placebo-controlled study

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INTRODUCTION: Delirium is highly prevalent in the intensive care unit (ICU) and is associated with adverse clinical outcomes. At this time, there is no drug that effectively prevents delirium in critically ill patients. Alterations in melatonin secretion and metabolism may contribute to the development of delirium. Administration of exogenous melatonin has been shown to prevent delirium in non-critically ill surgical and medical patients. This trial will demonstrate the feasibility of a planned multicentre, randomised controlled trial to test the hypothesis that melatonin can prevent delirium in critically ill patients compared with placebo.

METHODS AND ANALYSIS: This feasibility trial is a randomised, 3-arm, placebo-controlled study of melatonin (2 vs 0.5 mg vs placebo, administered for a maximum of 14 days) for the prevention of delirium in critically ill patients. A total of 69 patients aged 18 years and older with an expected ICU length of stay >48 hours will be recruited from 3 Canadian ICUs. The primary outcome is protocol adherence (ie, overall proportion of study drug doses administered in the prescribed administration window). Secondary outcomes include pharmacokinetic parameters, incidence, time to onset, duration of delirium, number of delirium-free days, adverse events, self-reported sleep quality, rest-activity cycles measured by wrist actigraphy, duration of mechanical ventilation, ICU length of stay and mortality. Data will be analysed using an intention-to-treat approach.

ETHICS AND DISSEMINATION: The study has been approved by Health Canada and the research ethics board of each study site. Trial results will be presented at international conferences and published in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER: NCT02615340: Pre-results.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:7

Enthalten in:

BMJ open - 7(2017), 3 vom: 30. März, Seite e015420

Sprache:

Englisch

Beteiligte Personen:

Burry, Lisa [VerfasserIn]
Scales, Damon [VerfasserIn]
Williamson, David [VerfasserIn]
Foster, Jennifer [VerfasserIn]
Mehta, Sangeeta [VerfasserIn]
Guenette, Melanie [VerfasserIn]
Fan, Eddy [VerfasserIn]
Detsky, Michael [VerfasserIn]
Azad, Azar [VerfasserIn]
Bernard, Francis [VerfasserIn]
Rose, Louise [VerfasserIn]

Links:

Volltext

Themen:

Central Nervous System Depressants
Comparative Study
INTENSIVE & CRITICAL CARE
JL5DK93RCL
Journal Article
Melatonin
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 18.12.2017

Date Revised 11.03.2022

published: Electronic

ClinicalTrials.gov: NCT02615340

Citation Status MEDLINE

doi:

10.1136/bmjopen-2016-015420

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM270522476